Piezoelectric osteotomies in craniofacial procedures: a series of 15 pediatric patients. Technical note.

Frontoorbital advancement has become a standard method both to increase intracranial volume and to improve facial appearance in patients with syndromal or nonsyndromal craniosynostosis. Relevant complications of this procedure include severe hemorrhage and trauma to intracranial, orbital, or facial soft tissues, which mostly arise during the process of bone exposure or osteotomy. To minimize the risk of soft tissue injury and to increase the precision of the osteotomy, the authors applied a piezoelectric osteotome for frontoorbital advancement in 15 patients with craniosynostosis seen consecutively (mean age 11.3 months). They demonstrated that this new device can cut cranial bones using ultrasonic microvibrations created by piezoelectric effects. In all patients, this instrument allowed an easy and precise handling during osteotomy with a reduced amount of trauma to adjacent soft tissues and with no complications. Although the time required for piezoelectric osteotomy was longer compared with conventional techniques, the total operation time remained approximately the same because the preparation requirements are less extensive. Postoperatively, bone regeneration was uneventful. The authors conclude that this new technique of piezoelectric osteotomy is a valuable tool for craniofacial reconstructive surgery in pediatric patients.